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Preconception, pregnancy, childbirth and postpartum care

Postpartum care

This section includes RHL summaries of published systematic reviews on various aspects of pregnancy and childbirth, including preconception care, management of miscarriage, antenatal care, medical problems in pregnancy, disorders that might affect the unborn baby, complications arising during pregnancy, the induction of labour, and the care of the mother and newborn during and immediately after childbirth.

RHL Article

Late cord clamping (performed approximately 1 to 3 minutes after birth) is recommended for all births while initiating simultaneous essential newborn care. Early cord clamping is generally contraindicated.

WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage

RHL Article

Recommendations The use of formal protocols by health facilities for the prevention and treatment of PPH is recommended. (Weak recommendation, very-low-quality evidence) The use of formal protocols for referral of women to a higher level of care is recommended for health facilities. (Weak...

Treatments for breast abscess in breastfeeding women

RHL Article

Postnatal depression is a neglected area of clinical care and research, particularly in low-resource settings. In many settings, routine postnatal visits seldom take place, and when they do, routine screening for postnatal depression is seldom done. Many women suffer depression without being aware...

Antidepressant treatment for postnatal depression

RHL Article

This updated review found: This review focused on safety of use of misoprostol for prevention or treatment, and did not explore effectiveness of misoprostol in terms of blood loss. Outcomes of interest were death or severe morbidity (including major surgery, ICU admission, vital organ failure and...

RHL Article

This review aimed to assess whether extra fluid intake by breast-feeding mothers would increase milk production/supply and improve infant growth. One quasi-randomised study (involving 210 women) from the 1950s, that had evaluated the effect on breastfeeding outcomes of extra ﬂuid intake by breast-...

Extra fluids for breastfeeding mothers for increasing milk production

RHL Article

This review aimed to assess prophylactic use of agents such as ergotamine, ergometrine, methylergometrine, herbal therapies and homoeopathic remedies administered after delivery of placenta for prevention of postpartum haemorrhage. The five included randomized controlled trials (1466 women) were of...

Prophylactic interventions after delivery of placenta for reducing bleeding during the postnatal period

RHL Article

An updated version of this systematic review has been published and can be found online at www.cochrane.org . We will soon update the below RHL summary to reflect the updated findings of the systematic review. RHL Summary Findings of the review :In various medical or domestic situations, or to...

Methods of milk expression for lactating women

RHL Article

With the advent of Rhesus immunoglobulin, severe Rhesus D alloimmunization is rarely seen today. However, Rhesus D is not always easily available in all settings, and therefore it is important to know the minimum effective dose in order to conserve supplies. This systematic review aimed to assess...

RHL Article

An updated version of this systematic review has been published and can be found online at www.cochrane.org . We will soon update the below RHL summary to reflect the updated findings of the systematic review. Overall, available evidence suggests that postpartum contraceptive education may increase...

WHO recommendation on the use of fluid replacement for the treatment of postpartum haemorrhage

RHL Article

The current evidence is insufficient to support the policy of early postnatal discharge from hospital as routine practice. Early discharge after childbirth has already been implemented in many resource-poor countries for economic reasons. Health administrators need to be aware that the risks and...

Early postnatal discharge from hospital for healthy mothers and term infants

RHL Article

In under-resourced settings, breastfeeding education during the antenatal period delivered by multipurpose health-care workers chosen from the community can help with the early initiation of breastfeeding. Simple interventions after delivery – such as early rooming-in, skin-to-skin contact and...

Interventions for promoting the initiation of breastfeeding

RHL Article

There is limited evidence for the effectiveness of treatment of postpartum anaemia with erythropoietin. Also, there remains a risk of serious adverse reactions from erythropoietin. Simple and more cost-effective strategies - particularly oral iron therapy - are available to improve clinical...

Treatment for women with postpartum iron-deficiency anaemia

RHL Article

There is no evidence to recommend psychosocial interventions to prevent postpartum depression. In under-resourced settings emotional support during pregnancy and the postpartum period is usually provided by the woman's family. Efforts should be directed towards educating family members in the early...